Wednesday 12 December 2012 12.21 EST
First published on Wednesday 12 December 2012 12.21 EST

Among the thousands of protesters who took to the streets in Michigan on Tuesday against the state's right-to-work laws were hundreds dressed in pink T-shirts and waving banners, determined to highlight another issue they say is in danger of being overshadowed: the state's sweeping assault on women's health.

Last week, while much focus was on the union-limiting legislation going through the state legislature at the same time, a package of bills that would restrict women's access to abortions and could restrict birth control were passed by the state Senate. They will now be considered by the House.

One would allow physicians, hospitals and other health providers to refuse to provide services to patients when there is a "moral" or "conscientious" objection. It would also, on the same grounds, allow employers to refuse to pay for services. Michigan already has a conscientious objection provision that allows healthcare providers to refuse to perform abortions.

Other bills approved by the Senate would ensure that health plans participating in Michigan's proposed "Obamacare" health exchange would not cover abortions unless women seeking insurance buy an optional abortion insurance "rider" to have such services covered. The extreme measures were inserted into a package of bills to reform healthcare provider Blue Cross Blue Shield, into a nonprofit, mutual insurer.

In an editorial on Tuesday, the Detroit Free Press said the measures could turn Michigan into "the nation's most regressive state in terms of reproductive rights". It has described the idea that a healthcare worker can refuse to provide services to patients as "obscene" and has urged the state governor, Rick Snyder, not to sign them.

Republican senators have said they support them because people who are against abortion should not see their payments help to cover abortion. But Democrats and pro-choice campaigners say that insured people already help pay for other services they may object to, such as liver transplants for alcoholics.

Meghan Groen, the director of government relations at Planned Parenthood Advocates of Michigan, said it was an unprecedented attack on women's health by the Republican legislature, which has ignored the message sent to them by the election result.

Opposition to the measures have come from healthcare providers, the American Council for Civil Liberties and a huge number of Michigan women, she said.

Groen said the effect of the legislation was "extremely broad".

"We're not just talking about abortion or women's health. An insurer could refuse to provide coverage, an education provider could refuse to provide education, or counselling services. Any facility of institution can create a policy saying that they refuse to provide any service if it interferes with their conscience."

Groen said the legislation could take away benefits that 80% of plans in Michigan cover. "You are talking about taking away services that are currently permitted."

"The insurance ban would ban abortion coverage in all plans in the state of Michigan. This is very extreme in terms of any state that has restrictions on abortion. Back in 2001, we had an anti-choice Republican governor that vetoed such legislation."

After passing in the state Senate, the bills are expected to be heard in committee in the house this week.

According to Roger Kahn, a Republican senator for Michigan who broke with his party to vote against the bill, it could allow doctors to refuse to write birth control prescriptions and open the door to refusing other services.

"I don't know how this doesn't violate the oath I took, when I promised to resuscitate someone with TB or treat someone with Aids," he said, according to the Detroit Free Press.

Michigan is already expected to pass an omnibus House bill, which would restrict abortion access by imposing additional regulations on abortion clinics and effectively shutting some down.

The bills would prevent all insurance plans in Michigan from covering abortion unless a woman would die without the procedure.

The broad nature of the state bills have led to comparisons with Ireland, where last month a young pregnant woman died after an Irish hospital refused to perform an abortion that would have saved her life after she began miscarrying. The death of Savita Halappanavar caused outrage worldwide.

Writing in her blog on Monday, Jennifer Dalven, the director of ACLU's Reproductive Freedom Project, wrote that the Michigan bills were "dangerous and wrongheaded" and said: "to pass it in the wake of Savita's death is unthinkable".

She said: "A pregnant woman who enters an emergency room should be guaranteed that she will get the care she needs if something goes terribly wrong. This should go without saying, but apparently some Michigan politicians need reminding: saving a woman's life must be every hospital's first priority."

A conscience clause would reduce the number of facilities offering abortions in the state and, as many areas in Michigan are rural, it could affect some areas more than others.

Groen said: "In suburban areas, you could drive around and seek out a hospital that would treat you. But when you are in 80% of the state, you may have nowhere else to go."